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NPI Code Detail

MEDICARE: MISS EMILY C JUDY RPH

MEDICARE: MISS EMILY C JUDY RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist6565WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
16565OTHERWVLICENSE NUMBER

General Provider Information

NPI Number : 1669476040
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS EMILY C JUDY RPH
Provider Business Mailing Address
First Line : 24 N MAIN ST
Second Line :
City : PETERSBURG
State : WV
Zip : 26847-1518
Country : US
Telephone Number : 304-257-1044
Fax Number : 304-257-2681
Provider Business Practice Location Address
First Line : 24 N MAIN ST
Second Line :
City : PETERSBURG
State : WV
Zip : 26847-1518
Country : US
Telephone Number : 304-257-1044
Fax Number : 304-257-2681
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2005
Last Update Date : 07/08/2007

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Directions to “ MISS EMILY C JUDY RPH” Practice Location

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